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New York rates for HCPCS 22868

Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; second level (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$333.98 / $3,490.00 / $8,134.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,385.00 / $4,133.00 / $9,074.00
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$340.55 / $1,716.00 / $16,534.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.48 / $275.48 / $14,648.00
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$27.03 / $27.03 / $27.03
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$250.00 / $319.00 / $659.95
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$220.61 / $220.61 / $220.61
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.48 / $555.00 / $37,776.00
MVP Health Care
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$27.03 / $27.03 / $27.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$964.00 / $2,826.00 / $4,851.00
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.64 / $398.64 / $469.61